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Heller myotomy

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https://www.readbyqxmd.com/read/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28145968/outcome-of-peroral-endoscopic-myotomy-poem-for-treating-achalasia-compared-with-laparoscopic-heller-myotomy-lhm
#2
Lijun Peng, Shuni Tian, Chao Du, Ziying Yuan, Mingxiao Guo, Lin Lu
OBJECTIVE: Peroral endoscopic myotomy (POEM) is an emerging endoscopic treatment for achalasia and the long-term efficacy of POEM remains to be evaluated. This study compared the outcomes of POEM with that of the standard laparoscopic Heller myotomy (LHM) for achalasia. MATERIALS AND METHODS: Achalasia patients treated by POEM or LHM were retrospectively analyzed, with a minimum postoperative follow-up of 3 years. Perioperative outcomes and long-term outcomes including treatment success (Eckardt score ≤3), occurrence of gastroesophageal reflux disease (GERD) (GerdQ score ≥9) and quality of life (36-item short form) were compared...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#3
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
January 24, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28118216/retropharyngeal-perforation-with-an-esophageal-dilator-a-case-report
#4
Gregory J Blair, Robert Hsiung
Esophageal "bougie" dilators are frequently used during esophageal surgeries to facilitate reconstruction and manipulation of the esophagus. Insertion of such dilators is usually a blind technique and not without risk. We present a case of retropharyngeal wall perforation resulting from esophageal dilator misplacement in a patient undergoing laparoscopic Heller myotomy and reconstruction. This case report demonstrates the importance of communication between surgery and anesthesiology teams during placement of devices into the oropharynx...
January 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28099056/multidisciplinary-approach-to-esophageal-achalasia-a-single-center-experience
#5
Francisco Schlottmann, Ciro Andolfi, Robert T Kavitt, Vani J A Konda, Marco G Patti
BACKGROUND: The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. MATERIALS AND METHODS: A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed...
January 18, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28052278/diagnosis-and-treatment-strategy-of-achalasia-subtypes-and-esophagogastric-junction-outflow-obstruction-based-on-high-resolution-manometry
#6
REVIEW
Eikichi Ihara, Kazumasa Muta, Keita Fukaura, Kazuhiko Nakamura
BACKGROUND: Based on Chicago Classification version 3.0, the disorders of esophagogastric junction outflow obstruction (EGJOO) include achalasia (types I, II and III) and EGJOO. Although no curative treatments are currently available for the treatment of the disorders of EGJOO, medical treatments, endoscopic pneumatic dilation (PD), laparoscopic Heller myotomy (LHM), and per-oral endoscopic myotomy (POEM) are usually the sought-after modes of treatment. Since the etiology and pathogenesis might vary depending on the types of EGJOO disorders, treatment strategies should be considered based on those subtypes...
2017: Digestion
https://www.readbyqxmd.com/read/28039638/effects-of-laparoscopic-myotomy-on-the-esophageal-motility-pattern-of-esophageal-achalasia-as-measured-by-high-resolution-manometry
#7
Renato Salvador, Edoardo Savarino, Elisa Pesenti, Lorenzo Spadotto, Guerrino Voltarel, Giovanni Capovilla, Francesco Cavallin, Loredana Nicoletti, Michele Valmasoni, Alberto Ruol, Stefano Merigliano, Mario Costantini
BACKGROUND: Esophageal achalasia can be classified on the grounds of three distinct manometric patterns that correlate well with final outcome after laparoscopic Heller-Dor myotomy (LHM). No analytical data are available, however, on the postoperative picture and its possible correlation with final outcome. The aims of this study were: (a) to investigate whether manometric patterns change after LHM for achalasia; (b) to ascertain whether postoperative patterns and/or changes can predict final outcome; and (c) to test the hypothesis that the three known patterns represent different stages in the evolution of the disease...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28011013/health-related-quality-of-life-after-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#8
Emanuele Asti, Andrea Sironi, Andrea Lovece, Giulia Bonavina, Melania Fanelli, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: In addition to symptom scores, a person's perception of health and quality of life assessment is an important indicator of quality of treatment and can provide an efficient index to compare different therapeutic modalities in chronic disease states. Only a few studies have investigated quality of life comprehensively in patients with achalasia, and therefore the controversy regarding the best treatment algorithm continues. The primary study outcome was pre- and postoperative quality of life in patients with achalasia undergoing laparoscopic Heller myotomy and Dor fundoplication...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/27973949/robot-assisted-heller-s-myotomy-for-achalasia-in-children
#9
Tariq Altokhais, Hala Mandora, Ayed Al-Qahtani, Abdulrahman Al-Bassam
BACKGROUND: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller's myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller's myotomy in children and presents a review of the literature. METHODS: Included in this study are children who underwent robot-assisted Heller's myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27928603/-laparoscopic-heller-myotomy-after-failed-poem-and-multiple-balloon-dilatations-better-late-than-never
#10
L Giulini, A Dubecz, H J Stein
BACKGROUND: Despite the lack of long-term results, peroral endoscopic myotomy (POEM) has been increasingly propagated as a feasible alternative to pneumatic balloon dilatation (BD) and laparoscopic Heller myotomy (LHM) in patients with achalasia. After a long-term follow-up, a large percentage of patients reported recurrence of dysphagia. It is unclear which kind of procedure (redo POEM or LHM) should be utilized in these patients with failed POEM. CASE REPORT AND RESULTS: We report the case of a 37-year-old female patient with type I achalasia who was successfully treated with LHM after a failed POEM procedure...
December 7, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27901639/results-of-laparoscopic-heller-s-myotomy-for-achalasia-in-children-a-systematic-review-of-the-literature
#11
Maurizio Pacilli, Mark Davenport
INTRODUCTION: Achalasia is a rare disorder in children who are commonly treated by laparoscopic Heller's myotomy (LHM). However, there are no large studies evaluating the results of LHM in the pediatric population, and the need of a concomitant fundoplication remains unclear. The aim of the study is to appraise the results of LHM based on a systematic literature review. MATERIALS AND METHODS: MEDLINE search of the English literature was performed for "achalasia," "children," "laparoscopy," "Heller," "myotomy," and "cardiomyotomy...
January 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27889484/refractory-pseudoachalasia-secondary-to-laparoscopically-placed-adjustable-gastric-band-successfully-treated-with-heller-myotomy
#12
Joseph Michael Losh, Barry Sanchez, Ken Waxman
No abstract text is available yet for this article.
October 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27858209/outcomes-in-patients-with-over-1-year-follow-up-after-peroral-endoscopic-myotomy-poem
#13
Marc A Ward, Matt Gitelis, Lava Patel, Yalini Vigneswaran, Joann Carbray, Michael B Ujiki
BACKGROUND: Peroral endoscopic myotomy (POEM) is a promising therapy in the treatment of achalasia. The study was designed to report outcomes, including quality of life, in patients with at least 1-year follow-up. METHODS: Patients from an institutional review board-approved protocol underwent POEM and were followed prospectively. Health-related quality of life was measured preoperatively and 1 year post-operatively using Short Form-36 Health Survey version 2 (SF-36v2)...
November 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27846179/real-time-continuous-esophageal-high-resolution-manometry-hrm-during-laparoscopic-heller-myotomy-and-dor-fundoplication-for-the-treatment-of-achalasia-a-promising-novelty-in-regards-of-perfecting-surgical-technique-could-it-guide-surgical-technique-toward-excellent
#14
Tania Triantafyllou, Georgia Doulami, Joanna Papailiou, Apostolos Mantides, Georgios Zografos, Dimitrios Theodorou
High-resolution manometry (HRM) is the gold-standard diagnostic tool for achalasia of the esophagus. Laparoscopic Heller-Dor technique is the preferred surgical approach with success rate estimated 90%. The use of intraoperative HRM provides real-time estimation of intraluminal esophageal pressures and identifies the exact points of esophageal luminal pressure during laparoscopy. Ten patients with achalasia underwent surgery. All patients preoperatively completed 1 manometric study and Quality of Life questionnaires (EORTC QLQ-C30 version 3...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27844266/poem-vs-laparoscopic-heller-myotomy-and-fundoplication-which-is-now-the-gold-standard-for-treatment-of-achalasia
#15
Marco G Patti, Ciro Andolfi, Steven P Bowers, Nathaniel J Soper
No abstract text is available yet for this article.
February 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27822780/intramural-esophageal-bronchogenic-cyst-mimicking-achalasia-in-a-toddler
#16
Jessica S Lin, Yangyang R Yu, Eric H Chiou, Bruno P Chumpitazi, Deborah A Schady, Mary L Brandt
Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered in the anterior esophagus at the level of the gastroesophageal junction and successfully resected with resolution of his symptoms.
November 7, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27822660/how-robotic-assisted-surgery-can-decrease-the-risk-of-mucosal-tear-during-heller-myotomy-procedure
#17
Quentin Ballouhey, Nabil Dib, Aurélien Binet, Véronique Carcauzon-Couvrat, Pauline Clermidi, Bernard Longis, Hubert Lardy, Jane Languepin, Jérôme Cros, Laurent Fourcade
We report the first description of robotic-assisted Heller myotomy in children. The purpose of this study was to improve the safety of Heller myotomy by demonstrating, in two adolescent patients, the contribution of the robot to the different steps of this procedure. Due to the robot's freedom of movement and three-dimensional vision, there was an improvement in the accuracy, a gain in the safety regarding different key-points, decreasing the risk of mucosal perforation associated with this procedure.
November 7, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27818585/update-on-the-endoscopic-treatments-for-achalasia
#18
REVIEW
Dushant S Uppal, Andrew Y Wang
Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. It is characterized by impaired deglutitive relaxation of the lower esophageal sphincter. High-resolution manometry allows for definitive diagnosis and classification of achalasia, with type II being the most responsive to therapy. Since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prevent end-stage disease. The central tenant of diagnosis is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27787481/complications-of-robotic-foregut-surgery-risks-and-advantages
#19
Ran B Luo, Domingo Montalvo, Toshiaki Suzuki, Bryan J Sandler, Garth R Jacobsen, Santiago Horgan
INTRODUCTION: Laparoscopic foregut surgeries are highly complex procedures that carry a high potential for morbidity and mortality should complications should occur. The robotic-assisted platform offers improved visualization of anatomy, optimal fine motor control, and a higher degree of instrumentation range of motion, which may potentially lead to better outcomes. This paper reviews the risks and benefits of the robotic platform in foregut procedures. EVIDENCE ACQUISITION: A web-based literature search was performed, in August 2016 using Pubmed, EMBASE, and Google Scholar from cited English publications from 1996 to 2016...
February 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/27756611/a-multicenter-international-registry-of-redo-per-oral-endoscopic-myotomy-poem-after-failed-poem
#20
Amy Tyberg, Stefan Seewald, Reem Z Sharaiha, Guadalupe Martinez, Amit P Desai, Nikhil A Kumta, Arnon Lambroza, Amrita Sethi, Kevin M Reavis, Ketisha DeRoche, Monica Gaidhane, Michael Talbot, Payal Saxena, Felipe Zamarripa, Maximilien Barret, Nicholas Eleftheriadis, Valerio Balassone, Haruhiro Inoue, Michel Kahaleh
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has become an accepted treatment for patients with achalasia. Despite its excellent efficacy rate of greater than 80%, a small percentage of patients remain symptomatic after the procedure. Limited data exist as to the best management for recurrence of symptoms after POEM. We present the first international, multicenter experience on the efficacy and safety of a repeat POEM in the management of achalasia. METHODS: Patients who underwent a redo POEM from 15 centers in 9 countries were included in a dedicated registry...
October 15, 2016: Gastrointestinal Endoscopy
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